Breathwork for Mental Health: Clinical Benefits for Anxiety and Stress
Breathwork is a popular and varied field for both mental and physical well-being, with some practices dating back thousands of years. While some breathing exercises for mental health are combined with physical exercises or cold water therapy, others focus solely on the breath.
Much research supports breathwork for anxiety relief, stress reduction, and other mental health benefits. But it’s important to note that people with cardiovascular conditions should explore these options carefully.
This article will explain what you need to know about the breathwork field, how breathwork therapy benefits mental health, and provide advice for getting started. It will cover:
- What breathwork is and the main types that are practiced today
- Clinical evidence for the effectiveness of breathwork on improving mental health
- How breathwork is thought to reduce stress by stimulating the nervous system
- Beginning breathwork and safety concerns
What is Breathwork?
Breathwork is the name for a broad range of techniques and approaches that play with and regulate the breath for therapeutic outcomes. Breathwork has been around for thousands of years and has emerged in many different cultures around the world. For example:[1]
- The Chinese breathwork practice known as Qigong
- Indian yogic breathing, also known as pranayama
- And more recently, the Wim Hof Method
Each approach varies in its intensity and desired outcome. You might use breathwork to enter a state of deep relaxation, to become energized, or to experience an altered state of consciousness.[2] Many treat breathwork as a form of lifestyle psychiatry, using it as a key component of a healthy lifestyle.
Types of Breathwork
As mentioned, there are numerous types of breathwork around the world, each with its own style and focus. Here’s some detail about the main ones you’ll encounter:
The Wim Hof Method
Wim Hof (a Dutch man also known as The Iceman), developed his breathwork method in combination with cold exposure techniques. The Wim Hof Method (WHM) has been studied many times, demonstrating positive outcomes for improving inflammatory disorders.[3]
The WHM invites people to hyperventilate (breathe at a rapid pace) between 30 and 40 times, followed by a period of holding one’s breath after exhaling most of one breath. This cycle can be repeated a few times. Alongside its breathwork component, the WHM also involves taking cold showers daily or sitting in an ice bath.[3]
Box Breathing
Box breathing is a very simple approach to breathwork, made up of four steps. Some like to visualize a box, with each of its four sides representing each step:
- Inhaling for 4 seconds
- Holding for 4 seconds
- Exhaling for 4 seconds
- Holding for 4 seconds
These steps should be repeated several times until you feel calmer. If 4 seconds is difficult, you can count to 3 seconds instead. This method is famously used by soldiers and police officers, as it’s a fast way to combat high levels of stress at work.[4]
Pranayama
Yoga is a 3000-year-old spiritual practice originating in India, encompassing physical, mental, emotional, social, and spiritual exercises and activities. Physical yoga (known as asana in Sanskrit) is the most famous aspect of yogic tradition. However, the philosophy also encourages ethical living, non-violent communication, and non-attachment to material possessions, among many other values.[5]
Pranayama is the breathwork part of yogic tradition, formed of two Sanskrit words: prana (meaning breath of life) and ayama (meaning expansion, control, and regulation). It involves a few different techniques, including:[6]
- Slow and deep breathing
- Rapid diaphragmatic breathing
- Alternate nostril breathing
- Breath holding
These exercises are usually done in a seated position. Pranayama has demonstrated numerous health benefits, which we’ll explore in the next section.
Qigong
Qigong is another ancient wellness practice, originating in China. As an aspect of traditional Chinese medicine, Qigong aims to optimize physical, mental, and spiritual energy. As well as breathwork, it combines physical activities and meditation.[7]
In Qigong, breathing is slow, deep, and long. Techniques might also involve speaking and chanting sounds aloud. You might have heard of tai chi, which is a form of Qigong.[7]
Clinical Mental Health Benefits of Breathwork
Many people strongly believe in the power of breath. Scientifically, we know that slowing our breath (such as to six breaths a minute) can induce relaxation and reduce stress levels. Furthermore, we can improve blood circulation to every part of the body by fully expanding our diaphragms.[1]
In addition, more specific research has been conducted into the particular types of breathwork listed in this article. Here’s what we know:
Mental Health Benefits of the Wim Hof Method
Research into the benefits of the Wim Hof Method finds that most participants report benefits to both their physical and mental health, such as increased mood, energy, and mental focus. People also report improvements in stress, tiredness, anxiety, depression, insomnia, arthritis, back pain, and chronic pain.[8]
Deep Breathing Health Benefits
Deep breathing research finds that techniques can significantly reduce stress hormones, like cortisol, an effect that is increased when practicing deep breathing over a long period of time.[4]
Furthermore, for people with stress and anxiety disorders (who tend to breathe faster and more erratically), long-term breathwork and meditation can reduce quick breathing. This suggests that breathwork could be helpful for people who experience panic attacks.[9]
Scientific Evidence for Pranayama
In terms of pranayama, studies find several positive health benefits, including stress relief, improved respiratory and cardiovascular function, enhanced cognitive performance, better sleep, and less fatigue.[5]
Mental Health Impact of Qigong
Similarly, Qigong is found to have many physical health benefits and is particularly ideal for older populations because of its low impact.[7] For mental health effects, there is good evidence to demonstrate Qigong’s effectiveness at reducing stress, anxiety, and depression; however, more research is needed to determine if it can treat specific conditions.[10]
While there’s a great deal of evidence to suggest breathwork can be powerful for mental well-being, it shouldn’t necessarily replace medical or therapeutic care in every case. If you’ve been in therapy or on medication for a number of years, speak to your doctor or therapist about alternative treatments. They’ll be able to support you in developing an integrated treatment plan.
Breath and the Nervous System
Underpinning modern breathwork practices is the idea that the nervous system can be manipulated and regulated with breath. To outline this idea, here are the basic facts to know:[11]
- During stress, the sympathetic nervous system carries signals that trigger the fight or flight stress response.
- Chronic stress and anxiety can cause us to be in constant fight or flight, instead of rest and digest, which is controlled by the parasympathetic nervous system.
- Our parasympathetic nervous system controls involuntary bodily processes, such as heart rate, immune response, and digestion.
- The vagus nerve is the longest cranial nerve in the body. It is the 10th of 12 paired nerves that run from the brain to our organs. It’s also the main nerve that instigates parasympathetic processes.
- There are a handful of actions that can stimulate the vagus nerve, bringing the body back into rest and digest.
Polyvagal theory is concerned with how we can regulate our nervous systems for better mental, physical, and social health outcomes. It suggests several ways to stimulate the vagus nerve in order to bring the body out of fight or flight. While this includes vagus nerve breathing techniques, it also includes:[12]
- Humming or chanting
- Meditation and mindfulness
- Dancing
- ‘Shaking off’ excess energy
- Self-soothing touch
- Cold water therapy
If you’re interested in trying nervous system regulation breathing, expect to come across something called diaphragmatic breathing. Also known as belly breathing, this approach draws in more breath from deep in the lungs, using a hand on your stomach as a guide.[12]
Furthermore, polyvagal theory emphasizes the importance of your exhale being longer and slower than your inhale. For example, inhaling for 4 seconds and exhaling for 8.[12]
How to Begin With Breathwork
Before diving into an intense breathwork activity, it’s a good idea to just become aware of how you tend to breathe throughout the day. From there, try to breathe through your nose most of the time.[1] Also, keep an eye on whether you’re shallow breathing – whereby you breathe a small amount of air into your lungs using your chest, not your diaphragm.
You might like to start with something simple, like box breathing, instead of activities that involve intentional hyperventilation. These more intense types of breathwork should be carried out in a safe and guided environment with experienced practitioners.[2]
Breathing techniques for stress can be simple at home, or you could attend specific classes in your local area. Some practitioners offer online classes via video call, but these might feel less safe as you’ll still be on your own. When attending classes (particularly those which promise consciousness-altering experiences or trauma healing through breathwork), always tell the practitioner that you’re a beginner.
Is Breathwork Always Safe?
Mindfulness breathing exercises for depression, stress, and general well-being are typically safe for most people. More intense breathwork activities may be unsuitable for some people with cardiovascular issues, such as those with asthma, chronic obstructive pulmonary disease (COPD), or who have experienced strokes.[1]
Mission Connection: Integrating Natural Approaches
If you’re someone who wants a natural approach, we can easily incorporate that into your treatment plan here at Mission Connection. Whether you want to learn stress reduction breathing methods, integrate light therapy, or engage in yoga therapy, your treatment will be personalized.
We operate from multiple facilities across the US, as well as offering online therapy, and treat a wide range of mental health conditions. Browse our therapies or take a self-test today to learn more.
